title: Developmental outcomes of children with congenital diaphragmatic hernia: a multicenter prospective study.
abstract: OBJECTIVE
  To determine developmental outcomes and associated factors in patients with congenital diaphragmatic hernia (CDH) at 2 years of age.
  
  
  METHODS
  This is a multicenter prospective study of a CDH birth cohort. Clinical and socioeconomic data were collected. Bayley Scales of Infant Development (BSID-III) and Vineland Adaptive Behavior Scales (VABS-II) were performed at 2 years of age.
  
  
  RESULTS
  BSID-III and VABS-II assessments were completed on 48 and 49 children, respectively. The BSID-III mean cognitive, language, and motor scores were significantly below the norm mean with average scores of 93 ± 15, 95 ± 16, and 95 ± 11. Ten percent (5/47) scored more than 2 standard deviations below the norm on one or more domains. VABS-II scores were similar to BSID-III scores with mean communication, daily living skills, social, motor, adaptive behavior scores of 97 ± 14, 94 ± 16, 93 ± 13, 97 ± 10, and 94 ± 14. For the BSID-III, supplemental oxygen at 28 days, a prenatal diagnosis, need for extracorporeal membrane oxygenation (ECMO) and exclusive tube feeds at time of discharge were associated with lower scores. At 2 years of age, history of hospital readmission and need for tube feeds were associated with lower scores. Lower socioeconomic status correlated with lower developmental scores when adjusted for significant health factors.
  
  
  CONCLUSIONS
  CDH patients on average have lower developmental scores at 2 years of age compared to the norm. A need for ECMO, oxygen at 28 days of life, ongoing health issues and lower socioeconomic status are factors associated with developmental delays.
authors.affiliation: Department of Pediatrics, Columbia University, New York, NY 10032, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Wynn
authors.forename: Gudrun
authors.initials: G
authors.lastname: Aspelund
authors.forename: Annette
authors.initials: A
authors.lastname: Zygmunt
authors.forename: Charles J H
authors.initials: CJ
authors.lastname: Stolar
authors.forename: George
authors.initials: G
authors.lastname: Mychaliska
authors.forename: Jennifer
authors.initials: J
authors.lastname: Butcher
authors.forename: Foong-Yen
authors.initials: FY
authors.lastname: Lim
authors.forename: Teresa
authors.initials: T
authors.lastname: Gratton
authors.forename: Douglas
authors.initials: D
authors.lastname: Potoka
authors.forename: Kate
authors.initials: K
authors.lastname: Brennan
authors.forename: Ken
authors.initials: K
authors.lastname: Azarow
authors.forename: Barbara
authors.initials: B
authors.lastname: Jackson
authors.forename: Howard
authors.initials: H
authors.lastname: Needelman
authors.forename: Timothy
authors.initials: T
authors.lastname: Crombleholme
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jimmy
authors.initials: J
authors.lastname: Duong
authors.forename: Marc S
authors.initials: MS
authors.lastname: Arkovitz
authors.forename: Wendy K
authors.initials: WK
authors.lastname: Chung
authors.forename: Christiana
authors.initials: C
authors.lastname: Farkouh
mesh_terms: D002653:Child Behavior Disorders / Q000175:diagnosis / Q000209:etiology*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006548:Hernia, Diaphragmatic / Q000150:complications / Q000601:surgery / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D010102:Oxygen Inhalation Therapy; D011446:Prospective Studies; D011581:Psychological Tests; D012307:Risk Factors; D012959:Socioeconomic Factors
keywords: BSID-III; Bayley Scales of Infant Development third edition; CDH; CI; Congenital diaphragmatic hernia; DHREAMS; Diaphragmatic Hernia Research & Exploration, Advancing Molecular Science; ECMO; HI; Hollingshead; Hollingshead Four Factor Index of socioeconomic status; Neurodevelopment; REDCap; Research Electronic Data Capture; SD; SES; Socioeconomic status; VABS-II; Vineland Adaptive Behavior Scales second edition; confidence interval; congenital diaphragmatic hernia; extracorporeal membrane oxygenation; socioeconomic status; standard deviation